It is well known in treating pneumothorax and other conditions of the pleural cavity that it is essential to remove excess fluids, blood, and gases, such as air, from the pleural space between the lung and the surrounding rib cage. Fluids may accumulate in the space between the lung and the chest wall as a result of surgery or from some other piercing of the rib cage, or from an illness. In such situations it is essential to the patient's survival that such fluids and/or gases be removed from the pleural cavity in order to maintain the lung in a fully expanded state and to restore pulmonary function.
There are know prior art devices and tehcniques for removing such fluids from the pleural cavity. These are known as the "one bottle", "two bottle" and "three bottle" systems.
The "one bottle" system consists of a single bottle with a connector adapted to be connected to the patient. The bottle contains a water seal and another opening which is an air vent.
The "two bottle" system consists of two bottles, the first being a collection bottle and water seal chamber attached to the patient and the second bottle being a suction control chamber. The first and second bottles are in fluid communication.
The prior art also includes what is known as the "three bottle" system. The prior art "three bottle" system utilizes a first or collection container in fluid communication with the patient and adapted to receive liquids and gases from the pleural cavity, a second container comprising a liquid seal which permits the evacuated gases to bubble out of the first or trap container and which prevents the flow of air back into the pleural cavity, and a third container which is a means of regulating vacuum or suction used to draw out the fluids and gases from the pleural cavity.
Thus in the "three bottle" system, one bottle serves as a trap container, a second bottle serves as a seal chamber and contains water to form that seal and the third bottle establishes the requisite negative pressure by being connected to a source of suction.
In the one, two and three bottle systems the water seal acts like a one-way valve, that is, it permits gases and liquid to be removed from the patient's pleural cavity but prevents the flow of gases back to the pleural cavity.
There are several disadvantages to the classical one, two and three bottle systems.
First, such systems have typically included glass containers or chambers with the resultant possible danger of breakage either during use or transport of the patient. Secondly, many such prior art systems employ corks and glass tubings with the possibility of leakage around the corks and glass tubings and breakage of the glass tubing either during use, assembly or disassembly. Of course, the two and three bottle systems greatly multiply the opportunity for such leakage and breakage due to the increased number of connections. Additionally, with some forms of the two and three bottle systems there is a danger of improper hookup to the patient even by skilled personnel.
Recently, some of the problems of breakage and leakage have been reduced by the use of a unitized plastic construction divided into a plurality of compartments or chambers which are constructed and arranged to perform the function of the three bottle systems. Such an arrangement is illustrated in U.S. Pat. Nos. 3,363,626, 3,363,627 and 3,559,647.
The unitized construction has the advantages of ease of transport and non-breakability.
There is a need, however, for an underwater drainage system which is reliable, relatively easy to manufacture, safe to operate, simple to understand, and not easily damaged. The underwater drainage system should be constructed so that the collection chamber can be easily emptied or samples taken therefrom for testing without disturbing the water seal or the manometer setting. Similarly, the water seal chamber should be capable of being filled accurately and expeditiously. The manometer chamber should be separable to permit ease in emptying or changing the level of liquid therein. The collection chamber, water seal chamber and manometer chamber should be in fluid communication by virtue of a manifold to which the collection and manometer chambers are removably attached.